What is acute renal failure? Features of acute renal failure

The article is professionally consulted by Specialist Doctor I Nguyen Hong Phuc - Emergency Department - Vinmec Phu Quoc International General Hospital.

Oliguria and anuria are characteristic of acute renal failure, a disease with a high mortality rate. Therefore, patients with acute renal failure need to be identified for timely treatment.

Acute kidney failure is a condition in which the function of the two kidneys is impaired or lost completely for a period of time, but only temporarily. Due to many different reasons, the functions of the kidneys are rapidly reduced or lost, causing the filtration rate of the microglomeruli to be completely reduced, causing oliguria and anuria, increasing the concentration of blood in the kidney. substances such as urea, creatinine in the blood, balances such as water - electrolytes, alkalinity - acidosis and some other balances in the body are disturbed...

Acute renal failure syndrome has the following characteristics:
Oliguria, prolonged anuria: The patient urinates little or no urine for about 1-3 weeks or longer. Blood urea and creatinine levels increase: When oliguria and anuria persist for a long time, the concentration of substances such as urea and creatinine in the blood will increase, the disease will become serious when the concentration of these substances increases. fast. Disturbances in water-electrolyte balance and acid-base: Prolonged oliguria and anuria also cause disturbances in body balances such as water-electrolyte and acid-base. High mortality rate: When the concentration of substances such as urea, potassium, ... in the blood increases, pulmonary edema will lead to death.

There are many causes of acute renal failure, however, the clinical symptoms and histopathology of the causes are similar.
Prerenal acute renal failure: Causes include volume shock due to trauma, burns, abortion, miscarriage, surgery, ... causing hemorrhage; cardiogenic shock due to myocardial infarction; Septic shock due to intestinal infection, sepsis and anaphylactic shock, causing acute renal failure. Acute renal failure in the kidney: Specific causes include heavy metal poisoning, toxins in the work or natural environment, antibiotics, anesthetics; kidney diseases such as renal vascular disease, glomerulonephritis , interstitial nephritis; renal obstruction due to crystals, causing acute renal failure. Post-renal acute renal failure: Possible causes include nerve damage causing bladder paralysis, pyelonephritis, ureteral obstruction, or bladder obstruction due to stones or tumors; mistakenly ligated the ureter during surgery, causing acute renal failure.

Acute renal failure progresses through 4 stages: onset, oliguria and anuria, urinary return, and recovery. Here are specific symptoms of the disease through each stage:
Initial stage: Depending on the cause of the disease, the patient will experience oliguria or anuria for different periods of time. Oliguria and anuria stage: At this stage, the patient begins to have oliguria or anuria that lasts for 1-2 days to several weeks. When oliguria and anuria persist for a long time, the amount of urea and creatinine in the blood will increase. When the concentration of these substances increases, the disease will progress more severe. At the same time, it also leads to disturbances in water - electrolyte balance and acid-base balance, causing edema, anemia, cardiovascular disorders, convulsions, vomiting, bleeding, difficulty breathing, coma,... This disease, if not treated promptly, can easily lead to death due to cardiac arrest, acute pulmonary edema, cerebral edema, and potassium poisoning. Urinary return stage: Renal function begins to recover, patients with acute renal failure will return to urinating with increasing frequency and volume of urine. Even so, if complications are not treated in the earlier stages, death is still possible, but the rate is lower when the patient is on hemodialysis. Recovery phase: If there are no complications, the patient's blood urea and creatinine levels decrease and gradually return to normal, kidney function and health recover.

The ability and degree of recovery of kidney function due to acute renal failure depends on many factors, including:
Causes of the disease: Acute kidney failure due to burns has very little ability to recover, the recovery rate for patients with acute renal failure is very low. obstetric, medical, trauma/surgery causes are 10-15%, 30% and 60%, respectively. Conditions for initial treatment: If not treated early, the mortality rate will be high. Treatment: Treatment of water-electrolyte imbalance is very important in the treatment of acute renal failure. Thus, if the patient is diagnosed, detected and treated promptly, in accordance with the correct and aggressive method, it is possible to restore kidney function almost completely or completely. Currently, using an artificial kidney for dialysis, while combining with conservative treatment, is an effective method in the treatment of acute renal failure. In contrast, if acute kidney failure progresses to chronic kidney failure, kidney function is gradually reduced with damage that will gradually lose the chance to recover.
Acute renal failure, with the main feature of oliguria or anuria, is a serious syndrome with high mortality if not promptly and appropriately treated.
BSCK I Nguyen Hong Phuc has nearly 20 years of experience in Emergency Resuscitation. Before being an Emergency Medicine Doctor at Vinmec Phu Quoc International General Hospital, Dr. Phuc worked at hospitals: Bac Ninh Lung Hospital, Cu Chi Regional General Hospital - Ho Chi Minh City Bright.
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